| NPI | 1295571453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 74177) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH996967) |
| 183500000X Pharmacist (Licence: GA RPH034487) | |
| Enumeration Date | 2024-07-06 |
| Last Update Date | 2024-07-06 |